Will the destruction be creative?

The large incumbent players (e.g. United, Humana) are largely built for a fee for service environment, and they’re best positioned to succeed in fee for service.

Entrenched interests are tough to navigate, but I would say that this crisis is forcing every line item and service provider to be scrutinized and see exactly what they’re providing. Right now, every buyer in healthcare is trying figure out how their different healthcare service providers can help them in a remote-first way, and most of these compa... See more

Because these companies are being built from the ground up, there’s disruptive potential against the larger incumbent insurers, who have optimized themselves around fee for service. These incumbents may not properly prioritize customer experience, since their success to-date has arisen from an adversarial relationship with providers that actually c... See more

Bright, Devoted, and Oscar have all structured their plans to financially align themselves with providers: when providers provide cost-effective care, both parties gain.

As this segment increases, more viable business models NATIVE to the cash pay population can be built.

The bearish case is that these businesses are very capital intensive to build, as shown by the large and repeated capital raises, and they’ll need to show a large return to justify that capital. That means operating at scale, and also escaping from the DTC markets into the large employer-driven insurance markets, where the incumbents will remain in... See more